FREQUENCY OF LEFT MAIN STEM AND PROXIMAL LEFT ANTERIOR DESCENDING ARTERY DISEASE IN DIABETIC PATIENTS PRESENTED WITH ACUTE MYOCARDIAL INFARCTION

Abstract

Background: Coronary artery disease remains a leading cause of morbidity and mortality among diabetic patients, with a higher likelihood of involvement of critical coronary segments such as the left main stem and proximal left anterior descending artery. Early identification of such high-risk lesions in patients presenting with acute myocardial infarction is essential for timely management and improved outcomes. Objective: To determine the frequency of left main stem and proximal left anterior descending artery disease in diabetic patients presenting with acute myocardial infarction. Study design: Descriptive cross-sectional study. Setting: Conducted at a tertiary care hospital. Duration of study: 22-02-2025—22-05-2025. Methods: This study included 122 diabetic patients aged 18 years and above presenting with acute myocardial infarction. Patients with prior percutaneous coronary intervention, coronary artery bypass grafting, chronic kidney disease, and chronic liver disease were excluded. All patients underwent coronary angiography to assess the presence of left main stem and proximal left anterior descending artery stenosis. Data were analyzed using SPSS version 26. Descriptive statistics were calculated, and stratification was performed to assess associations, with a p-value ≤0.05 considered statistically significant. Results: The mean age of patients was 46.50 ± 13.92 years, with a mean body mass index of 27.14 ± 2.14 kg/m². Males constituted 64.8% of the study population. Left main stem disease was observed in 7 (5.7%) patients, while proximal left anterior descending artery disease was found in 23 (18.9%) patients. Hypertension was present in 61.5% of patients. Stratification analysis demonstrated a significant association between proximal left anterior descending artery disease and both hypertension and older age. Conclusion: The frequency of left main stem and proximal left anterior descending artery disease among diabetic patients presenting with acute myocardial infarction was 5.7% and 18.9%, respectively. Proximal left anterior descending artery disease showed a significant association with hypertension and increasing age, highlighting the importance of early cardiovascular risk assessment in this population.